Cold and Flu Etiquette

How to Sneeze Politely and Respond with Consideration

by Tami Lancut Leibovitz

We are sitting in a lecture, a theatre or a cinema. Suddenly, the person beside us sneezes. Almost automatically, we turn our heads, shift away and think: “Please don’t let me catch anything. I have an important day tomorrow. Why did they come here ill?”

I use this example in my lectures because it reveals how quickly one person’s natural bodily response becomes another person’s judgment. Before we know anything about them, we have already assumed they are ill and inconsiderate. Sometimes our expression says more than words could.

This is where etiquette begins: in the way we treat people. The person who sneezed does not want to become the focus of attention or the reason the lecture stops. Equally, those nearby deserve a comfortable shared space and considerate behaviour. Cold and flu etiquette is about that mutual responsibility, at home, at work, in childcare and in public.

Not every sneeze needs a chorus

Many of us grew up with a simple rule: when someone sneezes, say “Bless you.” The intention is kind, and the gesture can feel warm and personal. But a habit learned in childhood need not become an automatic response in every setting.

Professional etiquette advice recognizes the importance of context. During a lecture, meeting or large gathering, saying nothing may be the more considerate choice. In November 2024, the German etiquette group AUI recommended letting sneezes pass without comment in formal situations and larger groups, partly to avoid adding to someone’s embarrassment. In a personal encounter, the other person’s habits and expectations also matter. [1]

For anyone accustomed to responding every time, this is the useful shift: you can be polite without saying “Bless you.” Silence can express a decision not to draw attention to an involuntary moment.

A quiet excuse me and then we move on

My advice to the person sneezing is simple: cover the sneeze, turn away from others and, if you have interrupted something, quietly say “Excuse me.” We are not apologising for having a body. We are briefly acknowledging an interruption.

Imagine someone sneezing during a lecture. It happens. They cover their sneeze, murmur “Excuse me,” and the speaker carries on. The speaker need not pause to offer a blessing, and the audience need not join in. There is no need to wait for a reply or thank several rows of people.

American etiquette writer Robert Dimmick, known as Etiquetteer, also cautions against calling a blessing from an audience to a stage or responding beyond the immediate conversational group. Such gestures can become distracting rather than helpful. [2]

We let the moment pass without turning a private concern into a public accusation. If we need more distance, we create it discreetly. Etiquette allows us to look after ourselves while preserving someone else’s dignity.

What if someone expects a blessing

Someone who is used to hearing “Bless you” may interpret silence as indifference. Explain the idea in a relaxed conversation, rather than giving an etiquette lesson immediately after their sneeze: “In a meeting or lecture, I prefer not to draw attention to it or interrupt.”

And if someone blesses us? A brief “Thank you” or a warm nod is enough, as the setting allows. There is no reason to tell them that “people don’t say that anymore.” Etiquette should put people at ease, not catch them out.

There is no universal ban on “Bless you.” Etiquette experts differ: Judith Martin, writing as Miss Manners, gives weight to the tradition and the affection attached to it. [3] The question I suggest asking is this: will my response make this person comfortable, or attract attention they did not ask for?

Sneezing politely in practice

Keep tissues within reach when possible. Cover your nose and mouth, and turn away from people and food. If you have no tissue, use the crook of your elbow, not your hand. There is no need to announce an approaching sneeze or describe it afterwards. [5]

If you need to blow your nose repeatedly, step away from the dining table or conversation and find a little privacy. Clean your hands after using a tissue. If a bout of sneezing is disrupting a talk, step out briefly if you can do so safely, without an elaborate apology. Others can allow you to leave without commentary.

Teach children calmly: “Into your elbow, please,” or offer a tissue. “That’s disgusting!” adds shame to a natural action. It does not teach consideration.

Repeated sniffing can also be distracting. Use a tissue and turn aside as needed. To help someone else, simply ask quietly, “Would you like a tissue?” Adding “It’s more pleasant and healthier” may sound like a reprimand. A discreet offer lets the person keep their dignity.

My used tissues are my responsibility

A used tissue does not belong on a meeting table, beside a keyboard, on an armrest or in an empty drinking glass. Nor should we leave a heap of tissues overflowing from an open bin for a colleague, host or cleaner to deal with.

In shared spaces, my recommendation is to use a bin with a lid that closes after use. If a suitable bin is not readily available, place used tissues in a small personal bag, close it and dispose of it promptly. Do not leave an open bag on the table or expect someone else to collect it.

This is a recommendation for keeping shared surroundings orderly and considerate. A lid is not a medical requirement for tissue disposal: the basic hygiene guidance is to put used tissues in the rubbish and clean your hands. [5] The point is to take responsibility for our personal waste.

A shared office means shared consideration

In an open-plan office, a cold is never entirely a private matter. There are colleagues, clients, meeting rooms, communal kitchens and shared workstations. The person beside us may have little choice about spending the day there.

When we are ill, the question is not simply “Can I manage to work?” It is also “What will my presence mean for everyone else?” Etiquette expert Diane Gottsman, founder of The Protocol School of Texas, makes staying away from the office when ill a matter of consideration for colleagues and clients. [4]

Let your manager know promptly and arrange a handover of urgent tasks. Consider remote work only if you feel well enough and your role permits it. Being ill does not oblige you to remain available from bed. Managers have a part to play too: support responsible decisions without praising those who “came in no matter what” or making an absent colleague feel they have let the team down.

When meeting colleagues or clients, a simple advance explanation can prevent awkwardness: “I’ll skip the handshake today. Thank you for understanding.” Do not lean over a colleague’s computer while coughing, leave tissues at a shared desk or mock someone who asks for more space or chooses to wear a mask.

If a colleague seems unwell, speak privately: “Could we arrange things so you can go home and rest?” If the difficulty continues, ask a manager to help find a solution. Calling across the room, “You’re going to infect all of us!” embarrasses the person without resolving the problem.

A colleague with a cough caused by a non-infectious condition does not owe the team their medical history. We can ask for consideration without demanding a diagnosis. Organisations should provide clear expectations and practical support, including tissues, suitable bins and access to hand hygiene.

There is no one to look after my child

It is morning. A child feels unwell, a parent needs to leave for work, no relative is available, and another absence could be difficult. We should acknowledge the pressure honestly: this is a real problem, and there may be no easy solution.

But when a child needs to stay home under the childcare setting’s illness policy, sending them in passes the difficulty to staff, other children and their families. The child also needs rest and care, rather than the effort of getting through a full day away from home.

Do not hide relevant information from staff or tell a child, “Don’t mention that you feel ill.” The decision affects more than our own working day. Parental responsibility includes consideration for the people who will care for the child.

Consideration must work in every direction: parents need to communicate honestly and follow the setting’s policy; staff need to respond consistently and respectfully; employers should explore flexibility that helps parents make responsible choices. “You’ll have to manage” is not a practical solution, and shaming a family in the parents’ group chat is not help.

Not every runny nose requires a child to stay home, and not every sneeze signals flu. Attendance decisions should follow the child’s condition and the relevant guidance, not other parents’ anger. Raise concerns directly with staff, without naming and blaming families in a group chat.

Being a considerate guest sometimes means staying home

If illness means cancelling, let your host know as early as possible: “I’m sorry to change our plans, but I’m not feeling well. I’d rather see you when I’ve recovered.” Do not arrive at the door and leave your host to ask you to go home.

Hosts can respond warmly: “Thank you for being considerate. We’ll see you soon.” Avoid pressure such as “But I’ve already cooked for you.” If someone in the host’s household is ill, let guests know and consider postponing.

See the person beyond the sneeze

A sneeze is a natural response. Leaving tissues for someone else, concealing relevant information or disregarding another person’s space are choices we can change. We take responsibility for our behaviour while avoiding accusing looks and reactions that make another person feel like a nuisance. Sometimes we offer a tissue or a kind word. Sometimes we simply let the lecture continue.

Not every sneeze needs a “Bless you.” Everyone deserves consideration.

“Etiquette is the human language that crosses borders, bridges differences and connects people.”